Results from a new study lend support to a new surgical technique for repair of torn anterior cruciate ligament (ACL) injury, one of the most common injuries of the knee. The study, conducted by researchers at University of Missouri School of Medicine, concludes that the newer approach achieves better graft integration, creating a stronger, more natural ACL repair than the traditional surgery now in common use. In this latter technique, graft-to-bone attachment is accomplished with screws securing the ligament to tunnels created in the bone. According to the study authors, this method of attachment has the characteristics of a spot weld vs a fully integrated repair and can result in a repair that is prone to later failure. Approximately 200,000 Americans experience a torn ACL and its resultant pain each year, with over 50% requiring surgical intervention. The findings appear in Journal of Arthroscopic & Related Surgery.

The research team developed a canine model that allowed the comparison of various surgical approaches to identify the best option for graft integration. One such option involves suturing the graft into sockets created in the 2 bones. According to senior author James Cook, DVM, PhD, this newer suspensory system “…allow(s) the graft the best opportunity to fully integrate into the bone like a normal ligament. The suspensory method also reduces cell and tissue damage to the graft.” The researchers found that only 4 of the 6 dogs treated with the traditional screw fixation method achieved full functional healing, and none of the grafts fully integrated into the bones like a native ligament. Of the dogs treated with the newer suspensory system, all 6 achieved functional and natural healing.